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DEATH
CERTIFICATE
TOBITHA BOLEN
Date 16 August 1924
Cert: # 28104
Name: Tobitha BOLEN
Place of Death: Voting Pct. Rock Fork, Knott Co., KY
Female, White, Single
Birth Date: 23 August 1922
Age: 01 years, 11 months, 25 days
Occupation: (blank)
Place of Birth: Knott Co., Ky.
Name of Father: George BOLEN
Birthplace Father: Knott Co., Ky.
Maiden Name of Mother: Della COBURN
Birthplace Mother: Ky.
Informant: J. M. BOLEN, Bolyn, Ky.
Death Date: 16 August 1924
Cause of Death: Summer complaint
Signed: George Bolen
Burial Place: Bolen
Date of Burial: 17 August 1924
Undertaker: J. M. Bolen, Bolyn, Ky.
File Date: (blank)
Transcribed by Debbie Tamborski, 10 December 2008 |
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